Program offers a longitudinal approach in place of high-stakes Part III exam
In January 2019, the American Board of Orthopaedic Surgery (ABOS) will launch a new Maintenance of Certification (MOC) Part III option to demonstrate evidence of cognitive expertise. The action is a positive development for those who don’t relish the prospect of taking a computer-based or oral examination every 10 years to recertify.

The new ABOS pathway to MOC, named the ABOS Web-Based Longitudinal Assessment (ABOS WLA) Program, will allow board-certified orthopaedic surgeons (Diplomates) to pursue and fulfill MOC Part III requirements through completion of a single annual assessment using a web-based interface to answer questions on a personal computer.

“This ABOS WLA Program represents the outcome of concerted advocacy on behalf of the membership by the Academy’s leadership to ABOS to express our belief that a one-time, high-stakes examination is not the best way to demonstrate ongoing competency,” said AAOS Immediate Past-President William J. Maloney, MD. “This longitudinal, ongoing assessment occurs every year through a series of questions that the Diplomate has some discretion to select. Keep up, and you will never have to take a high-stakes exam again. This new approach addresses the concern, in orthopaedic surgery and across other medical fields, that the MOC Part III process as it has historically existed can be onerous and not relevant to most practitioners.”

“As a board, we have worked very hard to create a variety of valid, carefully resourced, relevant pathways to assess recertifying Diplomates where they are in their individual practices,” said Peter M. Murray, MD, president of the ABOS. “Whether it is the ABOS WLA, one of eight practice-profiled written examinations, or an oral examination, the Diplomate may choose from a variety of different ways to meet the requirement for Part III MOC. We are excited about the launch of ABOS WLA in 2019 and appreciate the input from Dr. Maloney and the AAOS.”

The crux of the Knowledge Assessment component requires the Diplomate to answer a total of 120 questions correctly or achieve five “Quality Years,” over time, in one of the following two ways:

1. Accumulating Success (AS) method, by which a total of 120 questions are answered correctly in the annual assessment periods (five weeks in April and May) by the end of year six.
2. Quality Year (QY) method, by which 24 of 30 (80 percent) questions are answered in an annual assessment period to attain a QY with a total of five QYs needed. This method allows Diplomates to launch the process in any year of their current MOC cycle and maintain certification in the longitudinal path.

Questions will be drawn from a collection of “Knowledge Resources,” consisting of articles, practice guidelines, videos, webinars, and other content selected by 10 Knowledge Source Groups covering the major focuses of orthopaedic practice, including general orthopaedics. ABOS will work with the Academy and specialty societies to appoint members to the groups.

“We look forward to working with members of the AAOS and the orthopaedic specialty societies to ensure that the ABOS WLA is a valuable and relevant resource for our Diplomates,” said David F. Martin, MD, ABOS executive medical director.

The portfolio of Knowledge Resources will become available to Diplomates each January, at which time the Diplomate may select 15 Knowledge Resources (out of a planned 60 to 70) that they find most applicable to his or her own practice. In April of that year, 30 questions drawn from the chosen Knowledge Resources will be presented to the Diplomate to answer through the web platform. Three minutes are given for each question, and the Diplomate may use resources. After submitting an answer, the Diplomate will be informed if it was correct or incorrect.

Upon satisfying the Knowledge Assessment portion of MOC, the Diplomate enters the Application/Case List/Peer Review process portions of the ABOS MOC Program.

In addition, the ABOS and the Academy will work together to ensure that the ABOS WLA work will be eligible for CME credits at no charge to Academy fellows.

Another feature worth noting in the MOC process is the creation of a pathway for participation in the Qualified Clinical Data Registry—once that registry is approved—to be recognized for credit for Part II of ABOS MOC.

“The Academy and ABOS are committed to continuing their close collaboration in developing the questions used for the assessments,” Dr. Maloney said. “I would like to especially thank the current and past presidents of ABOS—Dr. Murray and James Roberson, MD—as well as Dr. Martin.”

“The Academy will be working to align its educational offerings to support our members to ensure they have the right educational tools,” he added. “And we will work to communicate and endorse the essential levels of competence that orthopaedic surgeons should maintain throughout their career.”

Terry Stanton is the senior science writer for AAOS Now. He can be reached at tstanton@aaos.org.